Ethical considerations
The Ethical clearance was obtained from the Ethics review committee of Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka under ERC/2019/22 and approved on 15/08/2019. Written informed consent was taken from all pregnant mothers to participate in this study as well as to use routinely collected data for this research purpose. The participants were informed that this research is conducted in parallel with the routine maternal and child health service and any “abnormality” will be reported to the health provider with the participant’s consent. In addition, consent had been sought for use of serum sample for screening of diabetes mellitus, liver biochemistry and serum cholesterol level and any other future studies, that may require baseline assessment of serum. Data was linked to the health records using a classified code, so that the confidentiality of data secured. Individual level data will not be presented in any form and summary data was used in research publications and data dissemination.